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NPI Code Detail

MEDICARE: MS. DEBORAH ARMINE HENDERSON M.A.

MEDICARE: MS. DEBORAH ARMINE HENDERSON M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1811160005
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH ARMINE HENDERSON M.A.
Provider Business Mailing Address
First Line : 6949 SADDLEBACK PL
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91701-4853
Country : US
Telephone Number : 909-563-8108
Fax Number :
Provider Business Practice Location Address
First Line : 1126 N GRAND AVE STE D
Second Line :
City : COVINA
State : CA
Zip : 91724-1552
Country : US
Telephone Number : 626-967-1667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2008
Last Update Date : 02/12/2010

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